| NPI | 1629513460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 102947) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA 102947) |
| 101YM0800X Counselor Mental Health (Licence: CA ASW84276) | |
| 106S00000X Behavior Technician | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2023-08-26 |